Doctors' Hospital nurse: Staff, supply shortages make work hazardous

By DUSTIN BLITCHOK

Friday, July 12, 2013

Financial problems at Doctors' Hospital of Michigan have led to shortages of basic supplies, inadequate security when patients attack staff and uncertainty every payday, according to employees and state reports.

"We have run out of linens," said one nurse, who asked not to be identified. "The hospital has run out of linens to where they were cutting up blankets to make towels for people to wash and dry with."

There have been shortages this summer of soap, toothpaste and bathing supplies, and in at least one instance "we were actually cutting up sheets to make arm slings," the nurse said. "Nurses have been using money out of their own pockets to buy soap, to buy medicine cups, to buy things for the patients."

The problem, said hospital Executive Director of Operations John Ponczocha, is that its laundry vendor burnt to the ground. The hospitals the vendor serviced "had to think very quickly on their feet to respond," he said.

As to supplies, Ponczocha said: "We've had some hiccups or we've had some challenges and, yes, the truck that delivers our chemicals, housekeeping and soap might not have come and we've run short of a particular item."

Interim CEO Dennis Franks said: "We've heard about this in the educational system many times, (where) circumstances dictate that teachers go out and buy supplies for their students, and that's in fact what's happening here." The staff "will ultimately be reimbursed," Franks said, "and there's no jeopardy in the quality of patient care being provided."

The nurse who spoke Friday about Doctors' Hospital said patients admitted to the hospital have gone so far as to leave, "informing their doctor that they are leaving because they are not being properly taken care of."

There have been dozens of employees laid off, and a recent payroll was made with assistance from eight of the 40 doctors who own the private hospital.

The hospital, the county's oldest, was city-owned for much of its history after opening at Huron Street and Johnson Avenue in 1909. After becoming North Oakland Medical Center, it closed briefly in 2008 after filing for bankruptcy, and was renamed Doctors' Hospital of Michigan after reopening and being purchased by physician investors.

"During these times, in all certain terms, there's never been a question of quality patient care being provided," said Interim CEO Franks. He and other top administrators said Friday that the hospital is fully accredited.

The Michigan Occupational Safety and Health Administration cited the hospital in June for failure to maintain a safe workplace where "employees were exposed to the hazard of being assaulted by violent patients while working in the emergency department." The hospital was fined a total of $5,200 by the state agency.

Between February and March of this year, "at least five separate workplace incidents occurred between emergency room employees and patients," one state citation said. As a result, the hospital is required to develop a Workplace Violence Prevention Program and must fix the problem by July 29. The fine for this citation was $4,500.

A second MIOSHA citation said an employee's workplace injury was not logged, resulting in a fine of $700.

Allison Brauer, the hospital's chief nursing officer, said the first two incidents that led to the MIOSHA inspection weren't reported.

"They had these incidents of violence that had occurred and nothing had been done and, unfortunately, it was because nothing had been communication to administration, per the hospital policy."

The good news, Brauer said, is that "once it was brought to our attention, we did what we needed to do and we did the right thing."

An inspection found that "emergency room employees had experienced varying degrees of verbal assault and physical assault," and security was "not always available to remain posted at the emergency room security desk because of low security staffing or because officers were needed to respond to emergency incidents throughout the hospital."

The report noted that additional security staff was hired just before the inspection began and panic buttons were installed in the hospital's emergency room.

The nurse who spoke with The Oakland Press said that a psychiatric patient injured her when he threw an object at her head earlier this year, and that a doctor was injured in a similar, separate incident.

"We were down to one or two security guards for the whole hospital," she said. "The number of injuries in the emergency room, on the psychiatric floor and on the regular floor were a daily occurrence. They were happening more frequently, and most of them were due to psychiatric patients, and they could be happening in several departments at the same time."

She said there was no mechanism in place to check for weapons, "and suddenly we're noticing knives" that patients have.

Ponczocha said the hospital has moved to a security model with four shifts and has additional employees available on a contingency basis. "We're providing, in some hours, more security than we had before," he said.

Three security officers were laid off, CEO Franks said, in what he said is hopefully only a temporary move.

"We also use other means to accomplish what we need for appropriate security at a lower cost, because these (contingency employees) are staff that don't receive benefits, because they're only called in when needed."

Recent paychecks have been paper only, with no direct deposit provided, the nurse said. She said payroll deductions for employees' health insurance aren't being forwarded to insurers: " ... A lot of us are getting told by our (insurers) that they haven't been paid by the hospital," leading to the denial of medical claims.

Interim CEO Franks responded: "I'm not even going out on a limb on this, to say nobody's been denied because of a lack of payment."

Ponczocha said payroll deductions must be forwarded within a certain number of days.

"The hospital, through this whole reorganization period, the timing of those payments may have been within a day or two (of the due date), at worst maybe within a week," he said. "It was never a case where the hospital was holding money for two weeks, three weeks, (or) a month to meet its obligations."

Doctors' Hospital of Michigan services about 12,000 indigent patients, or those unable to pay, annually.

"I do not want to see this hospital close because of the fact of all these people that do need to be taken care of," the nurse said Friday. "We need this hospital here."